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Early and Prehospital Thrombolytic Therapy in Acute Myocardial Infarction

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Limitation of Infarct Size

Abstract

Acute myocardial infarction is the consequence of sudden, complete obstruction of a major coronary artery [1]. It carries a mortality of about 10% with a significant morbidity [2]. Five distinct pathological processes take place in the infarct-related coronary artery.

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References

  1. DeWood MA, Spores J, Notske R, Mouser LT, Borroughs R, Golden MS, Lang HT (1980) Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. N Engl J Med 303: 897–902

    Article  Google Scholar 

  2. Corday E, Corday SR (1983) Advances in clinical management of acute myocardial infarction in the past 25 years. J Am Coll Cardiol 1: 126–132

    Article  PubMed  CAS  Google Scholar 

  3. Woolf N (1982) Pathology of atherosclerosis. Butterworth, London

    Google Scholar 

  4. Falk E (1983) Plaque rupture with severe pre-existing stenosis precipitating coronary thrombosis. Br Heart J 50: 127–134

    Article  PubMed  CAS  Google Scholar 

  5. Maseri A, L’Abbate A, Baroldi G, Chierchia S, Marzilli M, Ballestra AM, Severi S, Parodi O, Biagini A, Distante A, Pesola A (1978) Coronary vasospasm as a possible cause of myocardial infarction. A conclusion derived from the study of “preinfarction” angina. N Engl J Med 299: 1271–1277

    Article  PubMed  CAS  Google Scholar 

  6. Horie T, Seckiguchi M, Hirosawa K (1978) Coronary thrombosis in the pathogenesis of acute myocardial infarction. Br Heart J 40: 153–161

    Article  PubMed  CAS  Google Scholar 

  7. Muller JE (1983) Coronary artery thrombosis: historical aspects. J Am Coll Cardiol 1: 893–896

    Article  PubMed  CAS  Google Scholar 

  8. Rentrop KP, Feit F, Blanke H, Stecy P, Schneider R, Rey M, Horowitz S, Goldman M, Karsch K, Meilman H, Cohen M, Siegel S, Sanger J, Slater J, Gorlin R, Fox A, Fagerstrom R, Calhoun WF (1984) Effects of intracoronary streptokinase and intracoronary nitroglycerine infusion on coronary angiographic patterns and mortality in patients with acute myocardial infarction. N Engl J Med 311: 1457–1463

    Article  PubMed  CAS  Google Scholar 

  9. Jennings RB, Reimer KA (1981) Lethal myocardial ischemic injury. Am J Pathol 102: 241–255

    PubMed  CAS  Google Scholar 

  10. Reimer KA, Jennings RB (1979) The “wave front phenomenon” of myocardial ischemic cell death. II. Transmural progression of necrosis within the frame work of ischemic bed size (myocardium at risk) and collateral flow. Lab Invest 40: 633–644

    PubMed  CAS  Google Scholar 

  11. Mathey DG, Sheehan FH, Schofer J, Dodge HT (1985) Time from onset of symptoms to thrombolytic therapy: a major determinant of myocardial salvage in patients with acute transmural infarction. J Am Coll Cardiol 6: 518–525

    Article  PubMed  CAS  Google Scholar 

  12. Koren G, Weiss AT, Hasin Y, Applebaum D, Weiber S, Rozenman Y, Lotan C, Mosseri M, Sapoznikov D, Luria MH, Gotsman MS (1985) Prevention of myocardial damage by very early treatment with intravenous streptokinase. N Engl J Med 313: 1384–1389

    Article  PubMed  CAS  Google Scholar 

  13. Fine DG, Weiss AT, Sapoznikov D, Weiber S, Applebaum D, Lotan C, Hasin Y, Ben-David Y, Koren G, Gotsman MS (1986) Importance of early initiation of intravenous streptokinase therapy for acute myocardial infarction. Am J Cardiol 58: 411–417

    Article  PubMed  CAS  Google Scholar 

  14. Simoons ML, Serruys PW, Van den Braud M, Res J, Yerheugt FWA, Hanno Krauss X, Remme WJ, Bar F, DeZwaan C, van den Larse A, Vermeer F, Lubsen J (1986) Early thrombolysis in acute myocardial infarction: limitation of infarct size and improved survival. J Am Coll Cardiol 7: 717–728

    Article  PubMed  CAS  Google Scholar 

  15. Kennedy JW, Ritchie JL, Davis KB, Fritz JK (1983) Western Washington randomized trial of intracoronary streptokinase in acute myocardial infarction. N Engl J Med 308: 1477–1482

    Article  Google Scholar 

  16. ISAM Study Group (1986) A prospective trial of intravenous streptokinase in acute myocardial infarction. N Engl J Med 314: 1465–1471

    Article  Google Scholar 

  17. The GISSI Study Group (1986) Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1: 397–401

    Google Scholar 

  18. Yusuf S, Collins R, Peto R, Furberg C, Stamper MJ, Gaddhaber ST, Henmekens CH (1985) Intravenous and intracoronary fibrinolytic therapy in acute myocardial infarction: overview of results on mortality, re-infarction and side-effects from 33 randomized controlled trials. Eur Heart J 6: 556–585

    PubMed  CAS  Google Scholar 

  19. Sheehan FH, Mathey DG, Schofer J, Krebber HJ, Dodge HT (1983) Effect of interventions in salvaging left ventricular function in acute myocardial infarction: a study of intracoronary streptokinase. Am J Cardiol 52: 431–438

    Article  PubMed  CAS  Google Scholar 

  20. Applebaum D, Weiss AT, Koren G, Hasin Y, Gotsman MS (1986) Feasibility of pre-hos- pital fibrinolytic therapy of acute myocardial infarction by emergency medical services. J Emerg Med 4: 207–210

    Google Scholar 

  21. Weiss AT, Fine DG, Applebaum D, Weiber S, Lotan C, Sapoznikov D, Mosseri M, Ben- David Y, Hasin Y, Gotsman MS (1987) Prehospital coronary thrombolysis: a new strategy in acute myocardial infarction. Chest 92: 124–128

    Article  PubMed  CAS  Google Scholar 

  22. Norris RN, Whitlock RML, Barratt-Boyes C, Small CW (1975) Clinical measurement of myocardial infarct size: modification of a method for the estimation of total creatine phos- pho-kinase release after myocardial infarction. Circulation 51: 614–620

    PubMed  CAS  Google Scholar 

  23. Selvester RH, Wagner JO, Rubin HB (1972) Quantitation of myocardial infarct size and location by electrocardiogram and vectorcardiogram. In: Snellin HA (ed) Boerhave course on quantitation in cardiology. Leiden, University Press 2: 31–34

    Google Scholar 

  24. Hindman NB, Schocken DD, Windman M, Anderson WD, White RD, Leggett S, Ideker RE, Hinchara T, Selvester RH, Wagner GS (1985) Evaluation of a QRS scoring system for estimating myocardial infarct size. V: Specificity and method of application of the complete system. Am J Cardiol 55: 1485–1490

    Google Scholar 

  25. Sapoznikov D, Halon DA, Lewis BA, Gotsman MS (1981) Regional ejection fraction of the normal left ventricle. Isr J Med Sei 17: 1027–1034

    CAS  Google Scholar 

  26. Sapoznikov D, Halon DA, Lewis BS, Weiss AT, Gotsman MS (1983) Frame by frame analysis of the left ventricular function: quantitative assessment of regional and temporal function. Cardiology 70: 61–72

    Article  PubMed  CAS  Google Scholar 

  27. Sapoznikov D, Weiber S, Lotan C, Mosseri M, Shimoni Y, Gotsman MS. Quantitation of variations in regional left ventricular function in isolated disease of the left anterior descending coronary artery. Cardiology (In press)

    Google Scholar 

  28. Sherman CT, Litvak F, Grundfest W, Lee M, Hickey A, Chaux A, Kass R, Blanche C, Mat- loff J, Morgenstern L, Ganz W, Swan HJC, Forrester J (1986) Coronary angioscopy in patients with unstable angina pectoris. N Engl J Med 315: 913–919

    Article  CAS  Google Scholar 

  29. Essen R, Schmidt W, Uebis R, Edelman B, Effert S, Silny J, Rav G (1985) Myocardial infarction and thrombolysis: electrocardiographic short term and long term results using precordial mapping. Br Heart J 54: 6–10

    Article  Google Scholar 

  30. Fletcher AP, Alkjaersig J, Sherry S (1959) The maintenance of a sustained thrombolytic state in man: induction and effects. J Clin Invest 38: 1096

    Article  PubMed  CAS  Google Scholar 

  31. Smith RAG, Dupe RJ, English PD, Green J (1981) Fibrinolysis with acyl enzymes. A new approach to thrombolytic therapy. Nature 290: 505–508

    Google Scholar 

  32. Van de Werf F, Bergmann SR, Fox KA, Geest H, de Hoying CF, Sobel BE, Collen D (1984) Coronary thrombolysis with intravenously administered human tissue-type plasminogen activator produced by recombinant DNA technology. Circulation 69: 605–610

    Google Scholar 

  33. Verstraete M, Bory M, Collen D, Erbel R, Lennane RJ, Mathey D, Michels HR, Schartl M, Uebis R, Bernard R, Browler RW, DeBono DP, Huhmann W, Lubsen J, Meyer J, Rutsch W, Schmidt W, Essen R (1985) Randomized trial of intravenous recombinant tissue- type plasminogen activator versus intravenous streptokinase in acute myocardial infarction. Lancet 1: 842–847

    Article  PubMed  CAS  Google Scholar 

  34. The TIMI Study Group (1985) The thrombolysis in myocardial infarction (TIMI) trial - phase I findings. N Engl J Med 312: 932–936

    Google Scholar 

  35. Harrison DG, Ferguson DW, Collins SM, Skorton DJ, Eriksen EE, Kioschos JM, Marcus ML, White CW (1984) Rethrombosis after reperfusion with streptokinase: importance of geometry of residual lesions. Circulation 69: 991–999

    Article  PubMed  CAS  Google Scholar 

  36. Gangadharan V, Ramos RG, Hauser AM, Westveer DC, Timmis GG, Gordon S (1982) In- tra-coronary streptokinase: evidence for continued iatrogenic or spontaneous thrombolysis after termination of infusion. Am J Cardiol 49: 973

    Article  Google Scholar 

  37. Karsch K, Blanke H, Pichard A, Driesman M, Gorlin R, Teicholz LE, Rentrop KP (1981) Changes in the degree of stenosis of the infarct vessel following intracoronary streptokinase. Circulation 64: 105–107

    Google Scholar 

  38. Schroder R, Voringer M, Linderer T, Blamino G, Bruggermann T, Leitner ER (1985) Follow up after coronary arterial reperfusion with intravenous streptokinase in relation to residual myocardial infarct artery narrowing. Am J Cardiol 55: 313–317

    Article  PubMed  CAS  Google Scholar 

  39. Sheehan FH, Mathey DG, Schofer J, Dodge HT, Bolson EL (1985) Factors that determine recovery of left ventricular function after thrombolysis in patients with acute myocardial infarction. Circulation 71: 1121–1128

    Article  PubMed  CAS  Google Scholar 

  40. Gold AK, Leinbach RC, Palacios IF, Yasuda T, Block PC, Buckley MJ, Akins CW, Daggett WM, Austen WG (1983) Coronary re-occlusion after selective administration of streptokinase. Circulation 68: 150–154

    Google Scholar 

  41. Gash AK, Spann JF, Sherry S, Belber AD, Carabello BA, McDonough MT, Mann RH, McCann WD, Gault JH, Gantzler RD, Kent RL (1986) Factors influencing reocclusion after coronary thrombolysis for acute myocardial infarction. Am J Cardiol 57: 175–177

    Article  PubMed  CAS  Google Scholar 

  42. Gold HK, Leinbach RC, Garabedian HD, Tsunheiro-Yasuda Sin, Johns JA, Grossbard EB, Palacios I, Collen D (1986) Acute coronary re-occlusion after thrombolysis with recombinant human tissue-type plasminogen activator: prevention by a maintenance infusion. Circulation 23: 347–352

    Article  Google Scholar 

  43. Chesebro JH, Fuster V (1986) Anti-thrombotic therapy for acute myocardial infarction: mechanism and prevention of deep venous, left ventricular and coronary artery thromboembolism. Circulation 74 (Suppl 3): 1–10

    Google Scholar 

  44. Serruys PW, Wign SW, Van der Brand M (1983) Is transluminal coronary angioplasty mandatory after successful thrombolysis? Quantitative coronary angiographic study. Br Heart J 50: 257

    Article  PubMed  CAS  Google Scholar 

  45. Hammerman H, Kloner RA, Briggs LL, Braunwald E (1984) Enhancement of salvage of re- perfused myocardium by early beta-adrenergic blockade (timolol). J Am Coll Cardiol 3: 1438–1443

    Article  PubMed  CAS  Google Scholar 

  46. Nayler WG (1980) Cardioprotective effects of calcium ion antagonists in myocardial ischemia. Clin Invest Med 3: 91

    PubMed  CAS  Google Scholar 

  47. Shlafer M, Kane PF, Kirsh MM (1982) Superoxide dismutase plus catalase enhances the efficacy of hypothermic cardioplegia to protect the globally ischemic reperfused heart. J Thorac Cardiovasc Surg 83: 830–839

    PubMed  CAS  Google Scholar 

  48. Kitazume H, Iwama T, Suzuki A (1986) Combined thrombolytic therapy and coronary angioplasty for acute myocardial infarction. Am Heart Jill: 826–832

    Google Scholar 

  49. Hartzler GO, Rutherford BD, McConahay DR, Johnson WL, McCallister BD, Gura GM, Conn RC, Crockett JE (1983) Percutaneous transluminal coronary angioplasty with and without thrombolytic therapy for treatment of acute myocardial infarction. Am Heart J 106: 965–973

    Article  PubMed  CAS  Google Scholar 

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© 1989 Springer-Verlag Berlin Heidelberg

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Gotsman, M.S. et al. (1989). Early and Prehospital Thrombolytic Therapy in Acute Myocardial Infarction. In: Schmutzler, H., Rutsch, W., Dougherty, F.C. (eds) Limitation of Infarct Size. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-73585-1_14

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  • DOI: https://doi.org/10.1007/978-3-642-73585-1_14

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-19148-3

  • Online ISBN: 978-3-642-73585-1

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